EAST END ACADEMY INC SOUTHSIDE NPI 1578798849

NPI Information

NPI: 1578798849
Provider Name: EAST END ACADEMY INC SOUTHSIDE

Other Name: EAST END ACADEMY INC SOUTHSIDE

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
2607 COLONIAL AVENUE
NORFOLK, VA
ZIP 23517
Phone: (757) 275-7498
Get Directions

EAST END ACADEMY INC SOUTHSIDE is a mental health (including community mental health center) clinic center in Norfolk, VA. EAST END ACADEMY INC SOUTHSIDE NPI is 1578798849. The provider is registered as an organization entity type.
The provider Other Name Is East End Academy Inc Southside.

The provider's business location address is:

2607 COLONIAL AVENUE
NORFOLK, VA
ZIP 23517
Phone: (757) 275-7498
Fax: (757) 275-7561

The provider's authorized official is Ruby Eley .
The authorized official title is Ceo and has the following contact phone number (757) 275-7498.

The enumeration date for this NPI number is 5/15/2009 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)		VIRGINIA	No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	320	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	23517	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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